I have been on methadone for 3 years and it has helped me get off hydros. I recently went to my pm doc for a script and they made me take a urine drug screen that reflexes to gc/ms. I took some hydro the night before that was not prescribed from that DR.
How do these tests report, what should I tell my doc? I am so upset because I have been doing great with my methadone, I don't even like hydros, but when i can't get my Methadone in time it eases the w/d
did you say they already gave the test and it was a urine test? If so, they probably had the results in a few minutes, even before you left. If something had shown up they would have said something, or probably called you or sent a letter immediately, if it's been over a week, I would say you are probably okay.
The only way to be successful in PM is to be as honest and as compliant as possible. If I were you, I would flush any remaining narcotics you have that were not prescribed by your current doctor, then you dont have to worry about tests. If you need a dose increase or want a different med, then ask the doctor first, its really the only way to insure treatment long term, not to mention the fact that it can save your life from accidental overdose or drug interaction.
How much did you take? Have you been seeing this Doc for the 3 years you've been on methadone? What reaction do you think your Doc will have....ie. what is his/her general disposition? Have you failed a UA before with this Doc? Some more info will help before I can give my opinion.
What my new doctor said to me the first visit, and I consider him to be much stricter than my old doctor, was that I would be spot checked with a urine test, which I have been, and if my levels were off or there was another problem, he would work with me, but if there were illegal drugs in my system, that was it, see ya, wouldnt wanna be ya, lol.
So the good news is that you dont have any kind of street drug in your system which would probably be grounds for immediate dismissal.
Where did you get the hydro? had you had it for a long time, like from an old dentist appointment, or something? I would be prepared to let him know exactly where (and when) you got it.
Second, how much did you take? was it one dose, or had you been taking them for days? that might matter, using an old prescription as a one time breakthough med is not 100% kosher, but its not as bad as taking them every day for a week. Hydro has a pretty short life in urine, about 3-4 days, unlike some things such as THC (pot) which can show up in urine for a month. ( My sister is in law enforcement so I know some of this)
I am still not 100% clear on why you took the hydro, were you unable to fill your prescription on time, or did you run out a little early and suppliment to avoid withdrawal?
I dont think you are just for sure out on your ear, but honesty and full disclosure with the doctor is very important from this point on.
Sounds like you have an understanding Doc and he will probably work with you. You'll have to fess up though. I feel quite sure the test will show the hydro. As Fabby says, there is about a 3 day window. Hopefully, you didn't take much. If it was just one or two pills, you may escape all together....There is a "threshold" of which the amt of drug in your system must be over in order to show "positive." Drug screeners use this threshold whereas to not falsely accuse someone....It's usually the same screening method used for pre-employment, insurance exams, & etc. With a reasonable threshold, no one has to worry about eating too many poppy seeds on their hamburger buns & etc. Thus, you may escape if your metabolism is fairly good....If your hydro level is below the threshold, it will comeback as "negative." However, if you took a pretty good dose, it will show up.
PM Docs also employ UAs to ensure you're taking the meds being scripted and not diverted. The absence of your meds will also get you discharged....Unless you tell them upfront you haven't taken them for a few days. This is why the nurses ask those questions before a UA.
The UAs break down the results by drug....They separate out Hydros, Oxys, fent, codeine, & etc....Then, they also test for Meth, Coke, Pot, & etc. As Fabby says, illegals are obviously the worst. However, some Docs won't forgive a prescription drug in your system that they didn't prescribe.
PM Protocol calls for the Doc to meet with any patient who "fails" a UA...To discuss the outcome and if by chance there is some reasonable explanation. Sounds as if your Doc will do at least this and if caught, you will have to fess up and be honest. Since he knows about your past, he may be forgiving of your re-lapse. Many would not, however.
It's also important to note that some Docs don't give patient the courtesy of a visit....They simply discharge them via a certified letter or nurse phone call. I completely disagree with this method, but some do employ it.
Good luck and hope everything turns out ok for you.
i'm not too worried about about being discharged as I am the embarrassement of it all. i just don't want to face him or the staff, infact the nurse giving me the test said, don't worry we now you are a "good" patient. and she referenced patients taking oky's when they are presciribed vicodins and the tests showing that.
in fact now i am even more scared because i took my methadaone on Friday night and they test was Monday........ I hope to god the methadone shows. they never asked me when the last time i took a dose was.
it's bad enough the pharmacy looks at me funny when i drop off my rx for methadone, but now I feel like all the staff and nurses at my doc are going to look down on me!
I'm almost certain the methadone will show up on your test results. This med gets stored in your body's tissues and it takes a really long time for it to stop showing up. Usually these tests are simply looking for the presence of particular meds, most often illegal drugs and the meds you are supposed to be taking. Rarely do they look for amounts, but it can be done. If they're just screening for drug presence you're OK - if they are measuring amounts then the methadone may appear low.
I'm sorry if you've already answered this, but did the doc's office simply get you the script for the methadone too late?
Yes Gc/ms will show levels of each drug. That's the type of test they do randomly here at work.
I'm sure the methadone will show up on the test since it is long acting. It may not be at the level the doctor expects to see as it is not a PRN medication. I ran out of my Oxycontin two days early one time and was drug tested. My doctor did not say anything to me after the test. Then again, I was not taking anything she had not prescribed.
As others have stated, if you are below the cut-off limits with the hydrocodone, it will not show up as a positive test. I would worry more about the hydro vs. the Methadone. I would just be honest and tell the doctor that it was an old prescription and to stay out of withdrawl, you had to take it. Maybe you need to be on a higher dose of Methadone if you ran out early? This does not sound like a big issue to me. I'm sure they will be understanding. Some doctors make a bigger deal out of it than others. It sounds like you have a pretty understanding doctor that will not throw you under the bus. Good luck and let us know how you come out.
There are many different tests and they range from simple ones that just show a generic 'opiate' positive or negative, along with a range of other drugs, for example, amphetamines, thc, and cocaine.
The one that has to be sent out will be more sophisticated, and may show an actual high/low level of each med. It is also almost a given that it will seperate oxys, hydros, methadone, etc.
As you said you arent worried about being discharged, so I recommend complete disclosure at your next visit, if possible bring the bottle that had the hydro in it so you can show him where and when you got it.
I think you should expect him to at least tighten up the rules on you, for instance you may be tested monthly for awhile, with the clear understanding that he wont tolerate another dirty ua.
We're all human and everyone makes mistakes, but PM with narcotics is actually a priviledge, and even a reasonable doctor will reach a limit where they will have no problem dropping you and leaving you in full withdrawal, you dont want that. Please keep posting and let us know how its going, good luck to you.
should i wait until he confronts me, or spill beforehand??
I will have to call in for another script in a couple of weeks and I don't want the nurse who gave me the urine test and called me a "good" patient to call me out. I just don't know what to do! I think it would be easier if I wasn't so close and friendly with the staff, it's just so humilating
i know i might seem obsessed about this, but i have been in agony since it happened
If it were me, I would wait. But you are the only one who can decide that. Do you have another appointment set? If it were me, I would go to that and see what happens.
~~I would call and make an appointment, if you dont already have one, then you can find out then what is going on, and in the meantime, if it pops up and he is angry, you already have an appointment, which means it is much more likely he will wait until then and let you tell your side, rather than seeing you have no appointment, and just sending you a letter.
Last edited by Fabrashamx; 05-01-2008 at 01:07 PM.
Sorry for the dilemma your in however it will most likely show up as they do an electrolite test which pinpoints each and every drug. The truth will set you free and your doc may or may not understand but if he does not you will just have to find another doc. Good Luck
I go and meet with him face to face every 3 months, so I have an appointment in June but i will need another rx before. For that i have to call the offfice and the nurse or phys assistant gets my chart writes the rx and gives it to dr to sign.
are they allowed to discuss your test results with you (i.e, nurses and pa's)